Shoulder Injury Related to Vaccine Administration, or “SIRVA”, appears as shoulder pain and limited range of motion occurring after the injection of a vaccine too high on the shoulder. The pain and other symptoms are thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle into and around the underlying bursa of the shoulder resulting in an inflammatory reaction. It can be extremely painful. SIRVA is caused by an injury to the musculoskeletal structures of the shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological injury and abnormalities on neurological examination or nerve conduction studies (NCS) and/or electromyographic (EMG) studies would not support SIRVA as a diagnosis. Therefore, if an individual has abnormalities on an EMG, there is likely a neurological injury involved rather than a SIRVA issue. A person injured by vaccination is considered to have a SIRVA claim if the person has the following:

• No prior history of pain, inflammation or dysfunction of the affected shoulder prior to vaccine administration;

• Pain occurs within a short period of time, typically within 48 hours of receiving the vaccination;

• Pain and reduced range of motion are limited to the shoulder in which the vaccine was administered; and

• No other condition or abnormality is present that would explain the patient’s symptoms.